Dating a pregnancy without ultrasound
For many women, especially after 8 weeks gestation, sufficient information about the baby may be obtained with transabdominal ultrasound only. However, in the early pregnancy, the developing embryo is very small at 6 weeks gestation, the baby is only mm long and a transvaginal ultrasound may be required to get a better image of the baby. Transvaginal ultrasound is safe and commonly performed during all stages of pregnancy, including the first trimester. It will not harm you or your baby.
Women's Health Care Physicians
This cross-sectional study included consecutive pregnant women receiving antenatal care at two tertiary health institutions in Enugu, Nigeria, from January 1, to March 31, The mean age of the women was Most ultrasound scans The majority of the respondents The worrisome confidence in ultrasound scan dating is a challenge to the prevention of prolonged pregnancy and its complications in our environment. Antenatal health education should discourage self-referral for ultrasound scan dating and emphasize its limitations in late pregnancy as well as the perinatal effects of prolonged pregnancy.
Knowledge of the expected date of delivery EDD and gestational age is essential in the management of pregnant women. Both are important for optimal prenatal, intrapartum, and postnatal care. For instance, reliable information about gestational age and EDD is useful in assessment of fetal growth during the antenatal period. In clinical practice, the gestational age and EDD are often determined using the LMP, except when the discrepancy between the LMP-derived gestational age or EDD and that of early pregnancy ultrasound scan exceeds 1 week; in this situation, the ultrasound scan estimates are more reliable and should be used.
Further, the rate of post-term pregnancy has been shown to decrease when early ultrasound scan is used in estimating the gestational age and EDD. The uncontrolled proliferation of ultrasound in Nigeria has further heightened the conflict between these two estimates of delivery date because pregnant women are increasingly having access to ultrasound scanning manned by various cadres of health workers, without information on its known limitations. This scenario is a big challenge in terms of prevention of prolonged pregnancy in our environment where women register late for antenatal care 9 and rarely have reliable early ultrasound scan results.
A scenario is often created where the attending medical practitioner feels the pregnancy is prolonged based on a certain LMP-derived EDD while the client holds a different view based on her ultrasound scan-derived EDD, and therefore refuses to accept induction of labor despite counseling. The aim of this study was to determine the perception and acceptability of menstrual dating EDD derived from LMP for timing of labor induction for postdatism by pregnant women who have a late pregnancy ultrasound scan.
Enugu State is one of the five states in the southeast geopolitical zone of Nigeria, and its capital city is Enugu. It has an average annual temperature of The state covers a land area of approximately 8, The Enugu State University Teaching Hospital, Parklane, is a state-owned teaching hospital located in the center of the Enugu metropolis. Both centers provide antenatal and postnatal care services to pregnant women in Enugu State. The commonest indication for induction of labor in the two hospitals and in our environment is prolonged pregnancy.
This was a cross-sectional study of consecutive pregnant women attending for antenatal care at the antenatal clinics of the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, and the Enugu State University Teaching Hospital, Parklane, from January 1, to March 31, Every singleton pregnant woman due for a routine delivery planning discussion at a gestational age of 36 weeks and beyond was eligible for the study.
Exclusion criteria included uncertainty of date, presence of contraindications to vaginal delivery, irregular menstrual cycle prepregnancy, use of hormonal contraceptives prior to pregnancy, or bleeding during pregnancy. After individual counseling of eligible participants, pretested structured questionnaires were administered to consecutive consenting women by trained medical interns.
Ethical clearance for the study was obtained from the institutional review board of the University of Nigeria Teaching Hospital, Enugu. Data collected included the sociodemographic characteristics of the respondents age, marital status, tribe, level of education, occupation, parity , opinions and preferences regarding LMP and ultrasound scan dates, and their attitudes toward postdatism and induction of labor in relation to estimated dates.
The primary outcome measure was willingness to accept induction of labor at an LMP-derived gestational age of 40 weeks plus 10 days when late pregnancy ultrasound scan-derived gestational age was less than 40 weeks plus 10 days. The first trimester was defined as a gestational age of 1—13 weeks, the second trimester as 14—27 weeks, and the third trimester as 28—42 weeks. Further, the early second trimester was defined as a gestational age of 15—22 weeks and the late second trimester as 23—27 weeks.
Frequency tables were generated for relevant variables. A P -value of less than 0. A total of questionnaires were administered, but only were completed correctly, giving a response rate of The mean age of the respondents was Most of the women Four hundred and thirty-one respondents The majority of respondents were multiparous Further details of the sociodemographic characteristics of the respondents are shown in Table 1.
The mean gestational age at recruitment and antenatal booking for respondents was Forty-one women 9. A majority One hundred and sixty-seven One hundred and ninety-one The remaining eight women 1. Specifically, On the other hand, All the women who responded positively Likewise, all the women who responded negatively Characteristics of respondents versus acceptance of labor induction for postdatism using menstrual dating. OR, odds ratio; CI, confidence interval.
This study demonstrates that pregnant women in Enugu, Nigeria, have poor knowledge of the limits of accuracy of late pregnancy ultrasound scan in estimating the delivery date. This poor knowledge invariably translated into the observed perception of respondents toward induction of labor for postdatism, as more than half of the women This attitude poses a great challenge to perinatal care in our environment because an ultrasound scan is usually carried out in the third trimester when the margin of error is up to 3 weeks.
Late booking for antenatal care might have strongly contributed to the poor uptake 7. The recent proliferation of ultrasound scan services in our environment came with a wave of optimism that ultrasound scanning could accurately determine all aspects of fetal well-being, hence only the well-educated or informed could question or resist its results. This misconception is further worsened by uncontrolled purchasing and use of ultrasound scanning machines by poorly trained personnel who advertise themselves as sonologists or sonographers.
What is even more worrisome is the increasing number of self-referrals for ultrasound by our pregnant women merely to know the EDD which they usually hold on to. Legislation to regulate the acquisition and use of ultrasound by health professionals in the country may help to keep this problem in check. Such legislation should also discourage self-referral by pregnant women for ultrasound.
This will further help to prevent our women from visiting poorly trained sonologists and guard against the possible effects of unreliable ultrasound scan results on maternal and neonatal health. Tertiary education was identified in this report as a strong determinant of acceptance of induction of labor for postdatism using the last menstrual date.
This may be explained by the expected impact of education on uptake of maternal and neonatal health services, as observed by previous authors. Also, the lesser educated are more likely to rely more on the impression created outside about a procedure like ultrasound, whether right or wrong. As pointed out by Olusanya et al, 12 the higher the educational status of the woman, the higher the social class, and this no doubt may explain the higher acceptance rate among women of higher social class than among women of lower social class.
This will help to reduce the incidence of prolonged pregnancy and its complications in our environment. The limitation of this study is that the willingness to accept labor induction was assumed to mean acceptance of induction of labor. It is likely that some of the respondents might have responded differently if their pregnancies were actually prolonged. However, the effect of this limitation on the study estimates is likely to be minimal.
Selection of respondents for this study was consecutive considering the short study period, and selection bias cannot be ruled out; a longer study period and use of probability sampling would have been more appropriate. The strength of the study is that it is a novel effort toward stimulating the interest of physicians involved in maternal care regarding the increasing wave of self-referral for ultrasound scan in pregnancy in our environment, and the strong value mothers attach to ultrasound scan dating.
In conclusion, this study shows that in cases where late pregnancy ultrasound scan-derived EDD is further on than the menstrual dating, most women seen in the antenatal clinics at the teaching hospitals in Enugu would not be willing to accept labor induction for postdatism based on their menstrual dating. This worrisome attachment to ultrasound scan dating is a challenge to the prevention of prolonged pregnancy and its complications in our environment.
Predictors of this attitude in our study were low educational status, low social class, and poor knowledge of the limitations of late pregnancy ultrasound scan dating. Antenatal health education should discourage self-referral for ultrasound scanning and emphasize the limitations of late ultrasound scan dating as well as the perinatal effects of prolonged pregnancy. Educational campaigns are also encouraged regarding the need for early antenatal booking and accurate determination of EDD and gestational age during pregnancy.
National Center for Biotechnology Information , U. Int J Womens Health. Published online Feb Author information Copyright and License information Disclaimer. The full terms of the License are available at http: Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
Methods This cross-sectional study included consecutive pregnant women receiving antenatal care at two tertiary health institutions in Enugu, Nigeria, from January 1, to March 31, Results The mean age of the women was Conclusion The worrisome confidence in ultrasound scan dating is a challenge to the prevention of prolonged pregnancy and its complications in our environment. Introduction Knowledge of the expected date of delivery EDD and gestational age is essential in the management of pregnant women.
Materials and methods Study area Enugu State is one of the five states in the southeast geopolitical zone of Nigeria, and its capital city is Enugu. Study design and sample selection This was a cross-sectional study of consecutive pregnant women attending for antenatal care at the antenatal clinics of the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, and the Enugu State University Teaching Hospital, Parklane, from January 1, to March 31, Results A total of questionnaires were administered, but only were completed correctly, giving a response rate of Table 1 Sociodemographic characteristics of respondents.
Open in a separate window. Table 2 Characteristics of respondents versus acceptance of labor induction for postdatism using menstrual dating. Discussion This study demonstrates that pregnant women in Enugu, Nigeria, have poor knowledge of the limits of accuracy of late pregnancy ultrasound scan in estimating the delivery date.
Footnotes Disclosure The authors report no conflicts of interest in this work. References 1. Lynch CD, Zhang J. The research implications of the selection of a gestational age estimation method. Paediatr Perinat Epidemiol. Dating gestational age by last menstrual period, symphysis-fundal height, and ultrasound in urban Pakistan. Int J Gynecol Obstet.
Ultrasound in early pregnancy (before 12 weeks) – Dating Scan. Ultrasound in early pregnancy. Ultrasound: • Is a scan that uses sound waves to create a. A dating scan is an ultrasound examination which is performed in order to establish the gestational age of the pregnancy. Dating scans also reveal other.
You can calculate your due date by subtracting three months from the first day of your last menstrual period LMP and then add a week. Use our pregnancy calculator. A pregnancy is based on being days long, which is 40 weeks more like 10 months not 9! When we give you a due date we consider 37 to 42 weeks to be full-term, so even if your baby is born two weeks before your due date it is not considered premature. Because few women know the exact day they ovulated or conceived, an ultrasound done in the first trimester of pregnancy has been shown to the be the most accurate way to date a pregnancy.
The results of ultrasound testing provide you and your health care provider with critical information about you and your baby.
Pregnancy math can be a little murky. After all, unless you went the IVF-route, your physician has no way of knowing the exact time of conception.
How Doctors Date Pregnancies, Explained
NCBI Bookshelf. John A. Morgan ; Danielle B. Authors John A. Morgan 1 ; Danielle B.
First Trimester / Dating Ultrasound
This cross-sectional study included consecutive pregnant women receiving antenatal care at two tertiary health institutions in Enugu, Nigeria, from January 1, to March 31, The mean age of the women was Most ultrasound scans The majority of the respondents The worrisome confidence in ultrasound scan dating is a challenge to the prevention of prolonged pregnancy and its complications in our environment. Antenatal health education should discourage self-referral for ultrasound scan dating and emphasize its limitations in late pregnancy as well as the perinatal effects of prolonged pregnancy. Knowledge of the expected date of delivery EDD and gestational age is essential in the management of pregnant women. Both are important for optimal prenatal, intrapartum, and postnatal care.
A dating scan is an ultrasound scan to determine how many weeks pregnant you are and your due date. Read on for more information about what a dating scan offers.
Pettker, MD; James D. Goldberg, MD; and Yasser Y. This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed.
How Far Along Am I In My Pregnancy? 5 Ways To Calculate It
Knowledge is power, they say, and that's never so true as when you're calculating the time you've been pregnant. Whether pregnancy came as a surprise, or your baby was one of mice and men's best laid plans, when the urine test comes back positive, your first thought is likely to be, " How far along am I in my pregnancy? Experts say there are multiple ways to calculate how far along you are now in your pregnancy, including early ultrasounds, estimations based on later ultrasounds, measuring fundal height the distance between your pubic bone and the top of your bump after 20 weeks gestation, and good old fashioned counting back from your last missed period. First Response's website even offers a calculator which combines the date of your last missed period with your average cycle length to approximate a due date. But how many women know their average cycle length? Who even has a cycle anyone could call "average? According to Dr. For the rest, here are the options for determining how far along you are, from early to late. In an interview with Romper, Plancher explained that the absolute best way to calculate how far along you are is to come in for an early ultrasound as soon as you know you're pregnant. Your doctor can compare the data from that ultrasound with your last menstrual period to arrive at your due date. However, it's important to note that the earlier you receive your ultrasound, the more accurate it will be. Always test for pregnancy after a late period, and if it comes back positive, be sure to make an appointment right away.
First Trimester / Dating Ultrasound
A dating scan is an ultrasound examination which is performed in order to establish the gestational age of the pregnancy. Most dating scans are done with a trans-abdominal transducer and a fullish bladder. If the pregnancy is very early the gestation sac and fetus will not be big enough to see, so the transvaginal approach will give better pictures. Dating scans are usually recommended if there is doubt about the validity of the last menstrual period. By 6 to 7 weeks gestation the fetus is clearly seen on trans-vaginal ultrasound and the heart beat can be seen at this early stage 90 to beats per minute under 6 to 7 weeks, then to beats per minute as the baby matures.
When and Why Your Doctor May Change Your Due Date
A podcast about pregnancy and drug use, Native people and tribal sovereignty. When people discuss how far along in pregnancy someone is, they tend to do so in general terms: Medical professionals use a standard set of up to three methods to date pregnancies: That way, regardless of where they trained or where they practice, any two doctors dating a pregnancy will predict the same due date or gestational age. However, the timing of the actual delivery is not so predictable. Some women will deliver on their due date, others before, and others after.
Проваливай и умри. Он повернулся к Росио и заговорил с ней по-испански: - Похоже, я злоупотребил вашим гостеприимством. - Не обращайте на него внимания, - засмеялась. - Он просто расстроен. Но он получит то, что ему причитается.
На экране высветилось: СЛЕДОПЫТ ОТПРАВЛЕН Теперь надо ждать. Сьюзан вздохнула. Она чувствовала себя виноватой из-за того, что так резко говорила с коммандером. Ведь если кто и может справиться с возникшей опасностью, да еще без посторонней помощи, так это Тревор Стратмор. Он обладал сверхъестественной способностью одерживать верх над всеми, кто бросал ему вызов.
Шесть месяцев назад, когда Фонд электронных границ обнародовал информацию о том, что подводная лодка АНБ прослушивает подводные телефонные кабели, Стратмор организовал утечку информации о том, что эта подводная лодка на самом деле занимается незаконным сбросом токсичных отходов. ФЭГ и экологи так и не смогли установить, какая из двух версий соответствует истине, и средства массовой информации в конце концов устали от всей этой истории и перешли к другим темам.
- Это все, что у меня. - Боже мой! - Она улыбнулась. - Вы, американцы, совсем не умеете торговаться. На нашем рынке вы бы и дня не продержались. - Наличными, прямо сейчас, - сказал Беккер, доставая из кармана пиджака конверт.FIRST ULTRASOUND!! 8 WEEKS PREGNANT 👶🏻